According to the research, there are few demonstrable safety or health benefits from occupational licensing laws.
The number of studies that find positive health and safety effects from licensing are very rare. In fact, licensing experts could only point to one study which has found evidence of licensing requirements leading to an improvement in consumer health.[*] Kleiner said that in all of his research on occupational licensure he has not found any positive effects for public health and safety when it comes to state licensing laws. And even in the cases where it might, the economic costs of doing so still need to be weighed, and it is likely that many licenses would not pass a cost-benefit analysis.
One recent example of a study that found little benefit to public health and safety from a licensing regime was authored by Dr. Edward Timmons and Anna Mills. They looked at optician licensing from 1940 to 2012 and found that licensed opticians gained a wage premium increase of 0.3 to 0.5 percent annually. But they also looked at optician-related malpractice insurance premiums across the states and found no statistically significant difference in premiums among states that required an optician license and those that did not.
This suggests that opticians were no more likely to be sued for malpractice in states that did not require a license than in states that did. If licensing opticians provided a clear health and safety benefit, there should be fewer malpractice suits, and thus lower malpractice insurance premiums in states that require opticians to obtain a state license before they can legally operate.
Another recent study that analyzed the relaxing of licensing requirements and changes to the scope of practice for nurses found no influence on patient health. The report looks at states that allow nurse practitioners to perform a larger set of tasks without having to be under the supervision of a physician. It notes:
We find that when nurse practitioners have more independence in their scope of practice, their wages are higher but physicians’ wages are lower, which suggests some substitution between the occupations. Our analysis of insurance claims data shows that more rigid regulations increase the price of a well-child visit by 3–16 percent. However, we find no evidence that the changes in regulatory policy are reflected in outcomes that might be connected to the quality and safety of health services.
In other words, more stringent licensing laws raises the price of medical visits for children without promoting better care.
[*]That study found that the licensing of midwives from 1900 to 1940 caused a 6-7 percent decline in the mortality of the mother and perhaps a modest reduction in infant mortality. The study compared 22 states which licensed midwives during that time period to the states that were unregulated (though a “license” in some of the states could mean something as simple as receiving basic instruction from a local health professional). It states, “To our knowledge, our study is the first to provide econometric evidence that the adoption of licensing requirements leads to an improvement in consumer health. Whether requiring doctors, dentists and other health professionals to be licensed also leads to better health outcomes is an open, but crucial, question that deserves the attention of future researchers.” D. Mark Anderson et al., “The Effect of Occupational Licensing on Consumer Welfare: Early Midwifery Laws and Maternal Mortality,” NBER Working Paper, no. 22456 (July 2016): 27, https://perma.cc/ G4YP-6VN2.